Clinical Research Papers:
Clinical evaluation of stereotactic radiation therapy for recurrent or second primary mediastinal lymph node metastases originating from non-small cell lung cancer
Metrics: PDF 2730 views | HTML 3097 views | ?
Mao-Bin Meng1,*, Huan-Huan Wang1,*, Nicholas G. Zaorsky2,*, Xian-Zhi Zhao1, Zhi-Qiang Wu1, Bo Jiang1, Yong-Chun Song1, Hong-Qing Zhuang1, Feng-Tong Li1, Lu-Jun Zhao1, Chang-Li Wang3, Kai Li4, Ping Wang1 and Zhi-Yong Yuan1
1 Department of Radiation Oncology, CyberKnife Center, and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
2 Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
3 Department of Lung Cancer and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
4 Department of Thoracic Oncology and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
* These authors have contributed equally to this work
Ping Wang, email:
Zhi-Yong Yuan, email:
Keywords: local control, mediastinum, non-small cell lung cancer, stereotactic body radiation therapy, fractionated stereotactic radiation therapy
Received: December 17, 2014 Accepted: March 05, 2015 Published: March 30, 2015
Aims: To evaluate the safety and efficacy of stereotactic radiotherapy (SRT, both stereotactic body RT [SBRT] and fractionated stereotactic RT [FSRT]) in the treatment of patients with recurrent or second primary mediastinal lymph node metastases (R/SP-MLNMs) originating from non-small cell lung cancer (NSCLC).
Methods: Between 10/2006 and 7/2013, patients with R/SP-MLNMsoriginating from NSCLC were enrolled and treated with SRT at our hospital; their data was stored in prospectively-collected database. The enrolled patients were divided into Group A (without prior RT) and Group B (with prior RT). The primary end-point was overall survival (OS). The secondary end-points were the MLNM local control (LC), the time to symptom alleviation, and toxicity using the Common Terminology Criteria for Adverse Events (CTCAE v4.0).
Results: Thirty-three patients were treated (16 in Group A with 19 R/SP-MLNMs and 17 in Group B with 17 R/SP-MLNMs). For the entire cohort, the median OS was 25.5 months with a median follow-up of 20.9 months (range, 3.2-82). The 1-year and 3-year actuarial LC rates were 100% and 86%, respectively. Symptom alleviation was observed in 52% of patients, after a median of 6 days (range, 3-18). CTCAE v4.0 ≥ Grade 3 toxicities occurred in 5 patients (15%; all in Group B); among them, Grade 5 in 2 patients.
Conclusions: We recommend exercising extreme caution in using SRT for R/SP-MLNMs in patients who received prior RT (particularly to LN station 7). For patients without previous RT, SRT appears to be safe and efficacious treatment modality; prospective studies are warranted.
All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 4.0 License.